CAMPAIGN REPORT ON HEALTHCARE: Media mountain that GPs face. A buoyant pharmaceuticals industry generating lucrative display advertising has resulted in a plethora of medical titles, but do doctors want to read them all? Jonathan Holly reports

The amount of professional media a GP receives is huge. In some weeks, a doctor having a quiet week - a very rare occurrence - could plough through 360 tabloid pages delivered free to his or her door.

The amount of professional media a GP receives is huge. In some

weeks, a doctor having a quiet week - a very rare occurrence - could

plough through 360 tabloid pages delivered free to his or her door.



In addition, there are around ten fortnightly or monthly magazines, all

controlled circulation and dealing with practice, finance or clinical

issues.



This sector of the industry is kept afloat, or more accurately,

extremely profitable, by a single source of revenue; display advertising

from the pharmaceutical industry, a spend estimated at between pounds 30

million and pounds 35 million a year.



It is a relatively stable market, governed largely year on year by how

many drugs the industry launches. A pharmaceutical company’s adspend on

a launch is huge compared with the amount spent on maintaining a brand -

and last year proved a busy period. Of the top ten promoted products in

1997, half were launched the previous year.



The three weekly titles, Pulse, GP and Doctor, now account for 67 per

cent of the spend - or 55 per cent of the pages. This leaves 25 per cent

of the pages for the fortnightlies and 20 per cent for the

monthlies.



The spend reflects GPs’ position as gatekeepers of the NHS. Prescribing

by brand name is originated in general practice. Hospital doctors

contribute significantly less to the national drugs bill and tend to

prescribe generic rather then branded products. Prescribing by practice

nurses has had a patchy uptake but is in the process of being rolled out

nationally. However, this is unlikely to allow the nursing press to cash

in on the spend from drugs companies. Almost everything a nurse can

prescribe is already available over the counter.



The two main pushes for a drug company looking to establish a lead for

its product are print advertising and a targeted salesforce, with both

aspects co-ordinated especially for a launch.



The print advertising will often be there to simply establish brand

familiarity and very few include detailed clinical information about the

drug, except for the details demanded by legislation.



The sales representative will then follow up with one-to-one meetings

with GPs, using detail aids and leave pieces.



But it is the medical press that forms the mainstay of a company’s

promotional efforts and this is largely a result of the huge target

penetration they afford. Mike Bohling, the director of GEM Associates,

one of the leading media buyers in this sector, says of the market: ’GP

and Pulse record readership figures of 70 to 75 per cent each for an

average issue and I can’t think of any other market that could claim

that. It’s a huge penetration.’



A media buyer can approach 100 per cent penetration with the right

combination of titles.



Andy Thompson, publishing director of the medical division of Miller

Freeman, which publishes Pulse, agrees. ’It’s an unusual market in that

you can get 99 point something per cent of the potential readership by

using the media,’ he says.



Pulse fights a close-run battle for market leader status with GP. Doctor

lags behind by 15 points and the rest further still. The only exception

to this is MIMS, the Monthly Index of Medical Specialities, which

consistently scores higher than Pulse and GP.



MIMS is the only free title that sits on most GPs’ desks. It is a

detailed run-down of the majority of drugs a GP prescribes, providing

details of which conditions a particular drug is useful for and what to

look out for if a patient is taking it.



Its competitor is the British National Formulary, published by the

British Medical Association and the Royal Pharmaceutical Society, which

focuses on generic rather than branded goods and does not accept display

advertising.



Media buyers control the adspend of practically every pharmaceuticals

company. Glaxo Wellcome decided to place its spend in the hands of GEM

Associates late last year and became the last major company to do

so.



What is placed where and how much is paid for it depends almost

completely on a readership survey, JICMARS, the Joint Industry Committee

of Medical Advertisers for Readership Surveys.



Trying to get an idea of who reads what for a controlled circulation

market is notoriously difficult when ABCs tell you only how many are

being mailed out. The medical market is no exception. JICMARS is

financed by publishers and pharmaceutical companies through their media

buyers, and representatives from each contributor sit on the

committee.



A technical committee oversees the interviewing of 1,000 GPs to glean

their reading habits. Flash cards of covers are shown to them and the

degree of recognition recorded (see table).



The industry contributes to the pounds 160,000 cost of the survey,

although the bulk of the expenses are met by Haymarket, Miller Freeman

and Reed.



An extra pounds 50,000 is spent on the Taylor Nelson Hospital Readership

Survey which attempts to find out what the (less lucrative) hospital

doctor market is reading.



Bohling is sanguine about the accuracy of JICMARS and believes that the

way it ranks publications is more important than the actual figures.

’JICMARS is the common currency and that’s why it is used. Although

other surveys have been set up, JICMARS’ position has not really been

challenged,’ he says. ’As the for the precise nature and variance of the

readership figures, at the end of the day we still get to our target

audience in a very targeted way. But it’s true that we don’t have

anything approaching TGI.’



But publishers’ attitudes to how accurately their titles are served by

JICMARS are neatly - but predictably - divided by how well their titles

are doing.



Miller Freeman’s Thompson answers a firm ’yes’ when asked whether he

believes the actual figures to be accurate, as well as the trends and

ranking. ’Individuals express doubts about it from time to time but I

sit on the JICMARS committee and believe it to be a reasonably accurate

survey of readership,’ he explains.



A new system that aims to challenge JICMARS was launched early last year

but still has to prove its worth, according to publishers and media

buyers.



Topix allows existing databases to interact and includes a survey

involving 200 face-to-face interviews carried out every month.



Its panel consists of a sample that aims to be representative of region,

sex and size of GP practice, and it aims to have no duplicate interviews

within a 12-month period. It is only sold to the pharmaceutical industry

and publishers and the data is only available to media buyers through

these sources.



As a rival to JICMARS it is in its early stages and JICMARS ranking is

still the most important factor for media buyers. ’Because we and GP are

relatively close, if we ever went into second place it would be harder

to get the premium rate we do now,’ Thompson says.



Dr Farine Clarke, managing director of Haymarket Medical, publisher of

GP, MIMS and Medeconomics - which all score highly in JICMARS - is more

doubtful of the absolute accuracy of the figures per se.



A GP herself, she says: ’The numbers have a confidence interval of plus

or minus 3 per cent and therefore have to be taken in context. GPs do

not always answer the questions accurately.’



Ian Heslop, the publishing director of Reed Healthcare, which publishes

Doctor, Hospital Doctor and Update, says: ’JICMARS has always prided

itself on maintaining a very high standard and, although it has often

been criticised for being slow to react, that has been largely because

it has wanted to ensure that any changes to its methodology are well

researched.’



But he points out that his strategy is not only to pour resources into

improving the JICMARS score but also to create a brand rather than just

a title.



Brand extension is an activity all three of the major publishers are

involved in. Doctor has launched a credit card, a travel club, a club

for buying medical equipment and the prestigious Doctor of the Year

award for excellence in practice. In April last year, GP launched a

separate clinical title, GP Medicine, out of its parent title and also

produces a series of branded guides.



All the leading titles have plans to introduce online services but Pulse

will be the first off the blocks when epulse is launched this month.



Thompson says: ’This is not Pulse online but a new-media service that

will offer GPs the chance to buy services such as equipment for their

surgery, wine and holidays online. The opportunity to buy courses for

continuing medical education will also be included.’



Although the site has no sponsors as yet, Miller Freeman will welcome

applications from companies to display banners or links to their own

Websites when epulse is up and running.



However, Haymarket’s Clarke is doubtful about the current level of

demand for such a facility. ’Although GPs have computer systems to

generate prescriptions or keep patient records, our research shows that

very few access the Internet at the moment,’ she says. ’Having said

that, Haymarket Medical is actively developing an Internet site for

launch in the first quarter of 1998.’



Despite stories of the pharmaceutical industry falling on leaner times,

the future for the medical press looks stable. Although this year saw

media spend running at 5 per cent less than the previous year, it was a

good year for launches and the traditional fallow August period proved

to be unusually buoyant.



But a glance at JICMARS over the past year seems to suggest that the

level of readership is dropping across the board. GPs seem to be simply

reading less. Steve Lederer, the editor of Pharmaceutical Marketing and

ex-editor of GP, believes readership figures have been in decline for

some time, partly because of the increase in GPs’ workloads and also

thanks to the demands from other media.



’When I first joined the medical market ten years ago, we all knew that

the magazines would be delivered to a GP’s home on Thursday or Friday

and GPs would spend a lot of time enjoying them over the weekend, but

that perception is long gone,’ he says. ’Titles are now delivered to the

surgery earlier in the week and read quickly between seeing

patients.



The volume must be intimidating. I know from talking to GPs that many

find it distressing in terms of wasted resources, not only paper but

also in man hours.’



But a real decline in readership is simply not evident say the

publishers and yet another magazine joined the ranks last month.



Women in General Practice is published by Simon Warne at Emap

Healthcare. He says: ’The GP market has always been buoyant, supporting

a large number of titles headed by the big three weeklies. However, in

recent years GPs have been looking for more specialist publications

which cater more specifically for their needs - and this is certainly

true of women GPs.’



His optimistic attitude on the health of the GP market is shared by the

other publishers. Clarke says: ’The pharmaceuticals market is very

healthy and while GP and Pulse continue to get such huge coverage I

don’t really see the situation changing.’



Thompson agrees: ’I think in common with industries throughout the UK,

costs have been minimised in the pharmaceuticals industry but I would

strongly disagree with anyone who said the industry was scaling down in

any major way.





JICMARS Score 1997

PUBLICATION                      Jan-Dec 96     July 96-    Last six   %

                                                June 97     months

British Medical Journal          61             60          60        -1

Doctor                           65             60          57        -8

GP                               75             73          71        -4

Pulse                            76             73          71        -4

BMA News Review                  48             43          39        -9

Medical Monitor                  43             43          42        -1

Prescriber                       24             25          27        +3

Update                           48             46          43        -5

Financial Pulse                  47             45          46        -1

Medeconomics                     63             63          64        +1

British Journal of Cardiology    11             10          9         -2

Practitioner                     46             47          51        +5

MIMS                             82             83          83        +1

Medical Interface                4              5           6         +2

British Journal of General

Practice                         28             27          29        +1

Geriatric Medicine               17             16          16        -1

Health and Ageing                -              12          12       n/c



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